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Later, she was one of those people who quietly spent a lot of her time helping others.

The years passed and Joan grew old.

Her friends and family died or drifted away.

For a time, she got help to stay in her home -- meals and home care -- but it didn't last and she often ended up at hospital emergency rooms.

She's turning 86 now and lives in a tiny, dimly lit, shared room subsidized by the government.

A single bed, a dresser, a curtain over the closet.

There has been little contact with her family for 30 years.

She rarely gets visits.

Most of the time, Joan sleeps or waits for the pigeons to appear at her window ledge.

There's no TV.

Dementia comes and goes. Some days she feels well and whole, others are a blur of confusion.

Joan knows this isn't the way things are supposed to be.

"I feel like I'm living in an orphanage," she recently told a friend.

There are a growing number of Canadians like her.

Their isolation and circumstance vary greatly, but they share common problems -- elderly, little family or community support, dementia or other mental frailties, depression, health problems and for some, poverty.

They show up at hospital emergency rooms, they take up beds in hospitals and long-term care facilities because there's no other place to put them.

As Canada's baby boom ages, and our population of elderly citizens doubles over the next two decades, it's likely there will be an alarming increase in the number of these "shut-in" seniors.

What's clear to health experts dealing with today's seniors is the need for change in order to prepare for the boomers.

"We habitually punt people to the most expensive part of the system first," said Lori Holloway, national director of health programs for the Canadian Red Cross.

"If you have a problem, you're probably going to the hospital," Holloway said. "Sending a senior to a long-term care facility should be the last resort, not the first resort because we haven't got the supports in the community."

It boils down to simple math.

The cost to keep a person in a hospital for one day is $1,400, in a nursing home $175 and in supportive housing $75. Home care costs $45.

But historically, funding home care has not been a priority. Traditional funding models have focused on hospitals and long-term care homes.

That will have to change because boomers will demand it, Holloway said.

"What the public are saying, expecting and demanding is that they want to be at home as long as possible," she said. "Nobody says, 'I can't wait to go to long-term care. I can't wait to show up in hospital and not get out of there'."

Time is creeping up on boomers -- and on our health-care system.

Nadine Henningsen, executive director of the Canadian Home Care Association, said demand for home-care services has increased across the country by 55% over the past five years. Seniors represent 70% of that demand.

"What we're finding is there is an increase in demand and no corresponding increase in resources," she said.

Most provinces and territories spend just 4% of their annual health budgets on home care and most have not increased funding in years -- some have even reduced spending.

Government spends $8.9 billion to $10.5 billion on home and community care annually across the country, according to the Conference Board of Canada.

"Provinces are talking the talk, saying we need to shift care for our aging population, we need to have services and programs available for them, but the bottom line is they're not funding that talk," she said.

Because family and friends deliver 80% of home care services, caregiver burnout is a major concern, Henningsen said.

"We need to look at the role of the family caregiver and make sure we're not creating more patients," she said. "We need to provide flexible services to ensure the family caregiver can keep caring for their loved ones."

Because the status quo -- putting the elderly into long-term care facilities and hospitals -- is fiscally unsustainable.

Canadians 65 or older already consume 21% of emergency room visits, 39% of in-patient care, 60% of hospital bed days, 60% of hospital budgets and half the total health-care budget across the country.

The number of people aged 85 and older will quadruple during the next 20 years and 65-plus seniors will make up 25% of the population, up from the current 14%.

So things will get worse unless change is embraced.

Anthony Dale, interim president and CEO of the Ontario Hospital Association (OHA), said almost 3,900, mostly elderly people, languish in hospital beds in this province when they should be at home or in long-term care centres.

The story is much the same across the country.

And 14% of hospital beds in Ontario have patients, again largely seniors, who can't get the help they need to make the transition back into the community after a serious illness. They have been dubbed Alternate Level of Care (ALC) patients.

"Those aren't just numbers," Dale said. "They are people. They are people who ... are ready to go somewhere else better suited to the kind of care that they need."

That backlog has serious ramifications for the entire health system and illustrates how poorly funded home care has become in the province.

Dale and the OHA, have been advocating for increased funding for the home care sector even as funding for hospitals remains frozen.

It's the responsible thing to do, he said, and crucial to prepare for the baby boom demographic.

"We have 14% of patients in hospitals who actually shouldn't be there," he said. "They should be with their families.

"They should be living more independently than they can within a hospital, it's just they don't have access to the services they need to get there."